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目的:评价甲氨蝶呤联合米非司酮保守治疗异位妊娠的临床疗效与安全性。方法:2015年1月-2017年6月医院采用甲氨蝶呤联合米非司酮保守治疗异位妊娠37例。结果:成功35(94.6%),失败2例。出现β-HCG水平上升45.9%,出现腹痛29.7%、不良反应13.5%。治疗后月经恢复时间(53.1±5.6)日,月经失调18.9%。成功者中16例1次成功,2次及以上19例。1次成功者一过性HCG上升、腹痛发生率与孕周、血HCG水平低于2-3次成功者,差异有统计学意义(P<0.05)。结论:甲氨蝶呤联合米非司酮保守治疗异位妊娠疗效肯定,疗效与患者孕周、血HCG水平有关,越高则一次成功率越低。
Objective: To evaluate the clinical efficacy and safety of methotrexate combined with mifepristone in conservative treatment of ectopic pregnancy. Methods: From January 2015 to June 2017, 37 patients with ectopic pregnancy were treated conservatively with methotrexate and mifepristone. Results: Successful 35 (94.6%), failed in 2 cases. The level of β-HCG increased 45.9%, abdominal pain 29.7%, adverse reactions 13.5%. Menstruation recovery time after treatment (53.1 ± 5.6) days, menstrual disorders 18.9%. Among the successful patients, 16 cases were successful in 1 case and 2 cases and more than 19 cases. One time successful transcatheter HCG rise, the incidence of abdominal pain and gestational age, blood HCG levels less than 2-3 times successful, the difference was statistically significant (P <0.05). Conclusion: Methotrexate combined with mifepristone conservative treatment of ectopic pregnancy positive effect, and gestational age, blood HCG levels, the higher the lower the success rate.